Japanese Journal of Oral and Maxillofacial Surgery
Online ISSN : 2186-1579
Print ISSN : 0021-5163
ISSN-L : 0021-5163
Volume 62, Issue 1
Displaying 1-5 of 5 articles from this issue
Preface
Original article
  • Mana SHINNAKASU, Narihiro HIRAHARA, Tadashi SAKATA, Akinori GOMI, Etsu ...
    2016 Volume 62 Issue 1 Pages 3-9
    Published: January 20, 2016
    Released on J-STAGE: March 22, 2016
    JOURNAL FREE ACCESS
    Objective: Instruments for auditory assessment or sound analysis were conventionally used to evaluate abnormal speech sounds. However, since the representations by these subjective or objective methods are ambiguous and difficult to understand, they are not practical for feedback to patients in speech therapy. The purpose of this study was to analyze the articulation patterns of patients with mandibular prognathism using our speech visualization system and to evaluate the usefulness of this system.
    Subjects and Methods: The study group comprised 7 patients with mandibular prognathism who had undergone orthognathic surgery with glossectomy in our department (patient group) and 21 subjects with normal occlusion (normal group). All subjects pronounced 100 syllables containing the five Japanese vowel sounds and 50 words for assessment of articulation in a soundproof chamber, and the speech signals were converted into WAV-formatted digital data. In the speech intelligibility test, the 100-syllable recordings of the patient group were evaluated preoperatively and postoperatively by 5 listeners with normal hearing. Furthermore, the articulation pattern of the 50-word speech data was analyzed using our speech visualization system. In this system, the first, second, and third formant frequencies were converted into three primary colors, and the phoneme features of vowel sounds were represented as unique colors. At the same time, we designed a horizontal-vertical (hv) articulation diagram to represent the speaker's articulatory status, and compared the patients' distributions with normal ones as control. Moreover, the degree of distortion from the control distribution was quantified using a vowel balance chart. Using these visualization and quantification methods, we investigated the articulation changes of the patient group preoperatively and postoperatively and the differences between the two groups.
    Results: In the speech intelligibility test, speech intelligibility scores of the patients improved in postoperative recordings. In the hv articulation diagram, the distribution pattern of vowel sounds of the patients approached that of the control subjects postoperatively since some of the vowel sounds of the patients distributed outside of the normal range in preoperative recordings fell in the normal range in postoperative recordings. In the vowel balance chart, the pattern of the patients in postoperative recordings improved and was nearly similar to that of the control subjects.
    Conclusion: Speech visualization systems can be a useful tool for articulation pattern analysis in patients with mandibular prognathism.
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Case reports
  • Ryosuke ABE, Hirotaka SATO, Shintaro KOGI, Masaatsu YAGI, Genki YAMAYA ...
    2016 Volume 62 Issue 1 Pages 10-14
    Published: January 20, 2016
    Released on J-STAGE: March 22, 2016
    JOURNAL FREE ACCESS
    An 80-seven-year-old woman visited our department for further examination and treatment of a mass in the palate. A mass measuring 32×30 mm was detected in the region from the midline of the palate to the right alveolar part. The results of a biopsy were consistent with a diagnosis of carcinoma ex pleomorphic adenoma. Then, partial maxillectomy was conducted with the patient under general anesthesia. Histologically, the lesion was regarded as carcinoma ex pleomorphic adenoma consisting of the following three tumorous components: pleomorphic adenoma, basal cell adenocarcinoma, and squamous cell carcinoma. The possibility that pleomorphic adenoma has concomitant carcinoma should be considered, and particularly careful examination is necessary in cases that probably have a long past history.
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  • Rena SHIDO, Tokutaro MINAMIZATO, Nobutaka TAJIMA, Hiromi YAMASHITA, Sh ...
    2016 Volume 62 Issue 1 Pages 15-18
    Published: January 20, 2016
    Released on J-STAGE: March 22, 2016
    JOURNAL FREE ACCESS
    Most congenital teeth lack dental root formation and show remarkable mobility. They are often extracted owing to the risk of accidental ingestion and aspiration caused by abscission. Mass lesions including hard tissue formation rarely appear after tooth extraction or abscission. We report a case of epulis arising in the presumptive root formation region of congenital teeth, which progressed after tooth extraction, in an 8-month-old girl. The provisional clinical diagnosis was epulis fibrosa, and the mass was excised with the patient under local anesthesia. Histopathological examination revealed mesenchymal tissue proliferation accompanied by dentin formation, suggesting that the dental papilla participated in its occurrence. The prognosis was good as of 16 months after surgery.
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  • Ryohei ITO, Wataru KOBAYASHI, Kosei KUBOTA, Takao KON, Toshiyuki OSANA ...
    2016 Volume 62 Issue 1 Pages 19-24
    Published: January 20, 2016
    Released on J-STAGE: March 22, 2016
    JOURNAL FREE ACCESS
    Cystadenocarcinoma is an uncommon malignant salivary gland tumor that rarely occurs in the maxillofacial region. It accounts for less 0.2% of all salivary gland tumors. We report a case of cystadenocarcinoma arising in the upper lip. An 81-year-old man was referred because of a painless mass in the upper lip. Clinical examination revealed a well-circumscribed lesion 15 mm in diameter. The mass was elastic-firm, mobile, and nontender on palpation, and the overlying mucosa appeared normal. No cervical lymphadenopathy was noted. The clinical diagnosis was a pleomorphic adenoma. Because the patient refused surgical treatment, we took a “wait-and-see” approach. The mass enlarged gradually over the course of 8 months. We therefore performed magnetic resonance imaging (MRI). MRI revealed a 21×14×11 mm lesion in the upper lip. Based on a clinical diagnosis of a pleomorphic adenoma, we excised the tumor with the patient under local anesthesia. Histological examination showed that the tumor was well circumscribed, but not encapsulated completely. The tumor contained numerous cystic lumina of various sizes with papillary structures. The cyst walls were composed of cuboidal cells and tall columnar cells. The obtained specimen was histologically diagnosed as cystadenocarcinoma. Then, we performed additional excision. As of 20 months after operation, there have been no signs of recurrence or metastasis.
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